Mental Health Mentality: ‘We all have to take a role’

A law enforcement officer focuses on a worksheet while listening to the Hearing voices exercise during a seminar on interacting with citizens who may have mental health issues or be in a heightened emotional state.

This is the third in a three-part series examining the mental health program Shelby County Schools (SCS) will have in place in the 2018-19 school year.

Families, schools and professionals from all over the nation, including Shelby County, want to find solutions to mental health issues. But the complicated reality and prevalence of those issues make it clear that real change will require a multitude of efforts from all over the community.

As 280 Living previously reported, Shelby County Schools (SCS) will for the first time this school year take part in School-Based Mental Health Services (SBMH) through Shelby Cares, formerly Shelby County Cares. The school system will partner with Chilton-Shelby Mental Health (CSMH) in an official collaboration between the Alabama Department of Mental Health (ADMH) and the Alabama State Department of Education.

The school system is the 47th out of Alabama’s 136 total school systems to be involved with state and local resources and funding for mental health, but it isn’t the only part of Shelby County that’s taking steps toward educating the community.

Lt. Cody Sumners, who has been with the Shelby County Sheriff’s Office for almost 20 years, said the sheriff’s office is working to give law enforcement — both the officers out in the community and the student resource officers (SROs) in schools — the training to recognize symptoms and learn de-escalation techniques for crisis situations.

When Sumners met two years ago with current Shelby County Special Probate Judge Alison Boyd, who also acts as the mental health programs coordinator, it was apparent that a strong stigma, one that often discouraged people from getting the help they needed, still existed in the community about mental health.

Sumners made a goal for these training sessions to achieve a level of understanding and empathy of mental illness that “clicked” with officers.

“One exercise we do is the hearing voices exercises, where everybody has headphones on and are listening to voices for the entire time we are walking through different exercises,” Sumners said, which mimics what people with some forms of schizophrenia might experience in their day-to-day lives.

This year, the sheriff’s office also took the officers out for a community cookout at CSMH where patrons interacted with officers and both groups were able to ask each other questions.

These activities were set up so that officers could recognize signs and symptoms more readily and offer resources quickly and without judgment.

“That’s one of the things that we really started talking about, trying to get these people to help on the front end before it gets to the point where something bad comes out of it,” Sumners said.

This was the second year the department did a Shelby County-specific program, with local licensed therapists, clinicians and CSMH professionals taking part in the weeklong Shelby County Mental Health Crisis Response Training, partly in response to feedback that previous crisis intervention training wasn’t specific enough to the county.

With that feedback, Sumners said, they determined one of the keys to successful training is being able to put a name with a face.

“You can’t just say, ‘Oh well, the probate court is going to deal with that,’ or ‘the law enforcement is going to deal with that,’ [mental health] is something that we all have to take a role in and ask how can we address these bigger problems and how can we help to provide the support that people in the community need,” Boyd said.

During the program, officers are trained on recognizing signs and symptoms, understanding and preventing suicide, the how-to’s of interaction and identifying resources in the community that are available to be utilized.

“A lot of times, you’ll see the first signs of a mental illness in a high school or a middle school, so it’s important that [people at the school] are able to notice those things,” Sumners said.

All of the instructors, Sumners said, volunteer their time for the free classes and in July 2017, Sumners said, all Shelby County SROs were trained through the program.

Sergeant Reggie Parker of the Hoover Police Department’s crisis negotiation team discusses the use of effective pauses during a seminar on interacting with citizens who may have mental health issues or be in a heightened emotional state.

Between 2009 and 2012, state officials cut the mental health budget, according to ADMH, which shut down many of the state’s mental health facilities and limited the amount of funding for community-based programs.

Although the state budget this year allocated an $11 million increase for the Department of Mental Health, many mental health advocates, including National Alliance on Mental Illness (NAMI) Alabama, sought $90 million, some of which could fund programs similar to the Shelby County crisis intervention training and other mental health education classes.

Alabama Department of Health Public Information Officer Malissa Valdes-Hubert said almost all of their money goes to community programs, but many counties in Alabama are still operating on volunteer-run programs, private donations and funding from corporations to get employees — including teachers and school administrators — trained and educated about mental health.

With Shelby County Schools launching their new mental health awareness initiative, now called Shelby Cares, the Shelby County community continues to rise together to combat the stigma and bring awareness about mental health to its residents — despite the scarcity in state funding.

NAMI Alabama President Joan Elder said they have an affiliate for the Shelby County area, which she hopes to be active in Shelby Cares and be able to contribute to the program in impactful ways.

Specifically, Elder said, she wants to be able to provide their free flagship teen program Ending the Silence, a 50-minute class that covers warning signs of mental illness and suicide, ways to end the stigma and how to be a friend to someone in need. The program also brings in a young adult who lives with a mental illness to share their story, which Elder said has been really powerful in other school systems.

“We want people to talk about [mental illness], to bring it out into the open so that they aren’t afraid of it,” she said. “Other people can see that they are people that just have biological brain problems, sort of like cancer or diabetes.”

Elder said NAMI works to help people learn that they are not alone in their struggles.

“One in four people will deal with a mental health issue in their lifetime,” Elder said. “It’s just so common.”

The purpose of NAMI is “advocacy, education and support for people who live with a mental health condition, as well as their families,” Elder said. They offer monthly meetings and support groups. One of the most impactful resources offered, Elder said, is the Family to Family class.

Krista Chick, who is a licensed therapist and on the NAMI board, chose to attend the class last summer to try to improve her relationship with her mother, who has bipolar and borderline personality disorder.

“It honestly helped give me empathy toward her,” Chick said. “It didn’t change her but my perception of her changed, and I started to understand her illness and that she doesn’t choose to be this way. It is an illness that she has.”

Chick said even though she is trained as a mental health counselor, the reality of mental illness was still difficult for her to cope with, and she struggled to develop empathy, understanding and perspective when it was her own family.

“I mean, this is my mother, you know, this is someone who raised me and I grew up with and I’m still trying to have a relationship with, even though its really difficult,” Chick said. “Honestly, that was the biggest impact, being in a room with other people who have lived through the same situation.”

In the 12-week class, Chick said they do everything from role-playing scenarios to communication exercises to reading letters written by people struggling with mental illness. The class had a little over a dozen people, she said, and most of the people attending were parents of a teenager or child struggling with a mental health issue.

Elder said they also offer a 6-week class called Basics for Children, which is similar but geared toward adolescents in the school system.

Another free resource that became available for adults and parents in Shelby County this year is the Psychiatric Intake Response Center (PIRC), a service that offers a phone number to call for anyone with a mental health question or concern regarding a child or adolescent. PIRC can be reached at 638-7472 and is open seven days a week from 8 a.m. to 11 p.m.

PIRC Outreach Director Cindy Jones said the call center is a confidential resource that was created in March as a collaboration between Children’s of Alabama and the LaRussa Foundation of Hope.

Jesse Martinez, medical director of the new Birmingham-based Psychiatric Intake Response Center (PIRC), said that nationwide, there’s a trend of increasing demand for mental health resources and treatment for children and adolescents.

Suicide, according to statistics from the Centers for Disease Control and Prevention, remains the third leading cause of death in children and young adults ages 10 to 24.

Martinez said the resource was created after noting a growing trend of pediatric patients coming to the emergency room and having to be held for increased amounts of time for mental health issues, suicide prevention or a psychiatric evaluation.

“There is such a great need for mental health services for children and teens, and oftentimes people don’t know where to go to find those services,” Jones said. “If a parent calls, we have licensed mental health counselors and social workers who are on the phone.”

They ask questions and quickly assess the situation and determine what is the best resource or treatment option for them, Jones said. Martinez added that they are not a crisis call line, but instead a place to link families to resources.

“The goal for our program here is to really help families navigate the mental health care system, which can be very complicated in regards to knowing what resources are available,” Martinez said.

Sergeant Nina Monosky of the Hoover Police Department’s crisis negotiation team asks a series of questions to an officer participating in the Hearing Voices exercise.

Jones said they have a database that includes more than 500 resources for Jefferson, St. Clair, Blount, Walker and Shelby counties and have been averaging about 80 calls a month.

“We try to direct them to the right level of care. You have licensed professional counselors, you have a licensed social workers, PHDs or psychologists or psychiatrists. So there’s a lot of different levels,” Martinez said.

Jones said she has also been in contact with Shelby County Schools about opportunities to speak with counselors about PIRC’s services.

“There are a lot of parents who simply feel like their child is maybe going through something, and they’ll simply get over it. They’re not seeking out professional help. They might say, ‘I’ve never needed it, so why does my child need it?’ And I think that’s the education piece we provide,” Jones said.

In Alabaster City Schools, Jones said, they were able to send out a letter to parents explaining how to use their call line for their children. This is something they also hope to do in Shelby County, she said.

Stigma is definitely a hurdle that sometimes keeps people from calling, Martinez said, but financial and insurance questions are also a stumbling block. Since starting the call line, Martinez said they’ve realized a lot of resources offer a sliding scale pay system based on income, which can ease those worries. They also try to offer information on which insurance is accepted where.

Although SCS and the community are working hard to bring resources to families in the area, Elder said there is still more she would like to see done.

One example in Alabaster is the NAMI Mental Health Awareness FunFair that they had for the first time in May. The family-friendly event featured about 30 different booths of resources, children’s activities and food trucks, Elder said, and about 300 people came to the event.

Boyd, who also attended the event, said they are currently looking to get one set up in Chelsea and would like to set up other fairs in other communities if there’s interest.

“[The fair] was something that seemed to be very successful. It got great comments from the people who attended it,” she said.

Boyd said people were able to learn about new organizations and the service providers were able to connect and plan to collaborate on projects in the future.

For many events like the fair, Elder said, funding can be key.

The Mental Illness Policy Organization compiled a ranking system at the end of 2017 for the percentage of total state expenditures allocated to mental illness, and the state of Alabama is ranked 35 out of all 50 states, spending 1.5 percent. According to the data, the top state on the list spent 5.6 percent.

“We are absolutely trying to tell them we need more [funding],” Elder said. “The state [NAMI] organization is planning an event in March, right when the Legislature first meets, to again address those concerns that we have.”

A low-cost option for learning more is to have a certified Mental Health First Aid Course trainer teach an organization or school group an introductory course on identifying, understanding and responding to signs of mental illness.

Additional Services

Teen Link text services: Teens can text 205-382-5465 and talk to trained counselors about anything. The text messages will be kept confidential.

Crisis Lines: Locals can call the Birmingham Crisis Line at 205-323-7778 to talk on the phone with a trained counselor 24/7. If the line is busy, call the toll free National Suicide Prevention Lifeline at 1-800-273-8255.

Help finding treatment: Go to findtreatment.samhsa.gov to find support groups and local counselors and psychiatrists in your area.

PIRC can be reached at 205-638-7472 and is open seven days a week from 8 a.m. to 11 p.m.